title: Comparative evaluation of five needleless intravenous connectors.
abstract: OBJECTIVE
  The purpose of this study was to evaluate in vitro differences of colony forming units (CFUs), of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli), over 4 days, using bovine blood, in five intravenous needleless connectors (three negative, one positive, one zero).
  
  
  BACKGROUND
  Availability of colony forming units creates a definitive environment for bloodstream infections and occlusions. Protection of the intraluminal pathway is one important way to help eliminate occlusions and catheter-related bloodstream infections and utilization of best available product(s) will aid in best patient outcomes.
  
  
  METHODS
  Five different connectors evaluated in 2009 by an independent laboratory for in vitro differences about colony forming units of four different organisms over 4 days.
  
  
  RESULTS
  The Q-Syte™ performed poorly on all organisms (P<0·0001). The MaxPlus(®) Clear and MicroCLAVE(®) fluctuated between high colony forming units (28·15 & 56·55 respectively) and zero colony forming units. The TKO™Clave(®) stayed increased (high of 50·8 colony forming units). The RyMed-5001(®) performed the best with very low colony forming units (2·25 CFUs to zero).
  
  
  CONCLUSIONS
  Non-antimicrobial connectors differ on colony forming unit counts in vitro for four types of bacteria. Connectors with most colony forming units to least colony forming units included the Q-Syte™, TKO™Clave(®), MicroCLAVE(®), MaxPlus(®) Clear and RyMed-5001(®). Connectors are one statistically significant variable (50%) in the development of occlusions and infections. Staff nurses, managers, infection control specialists and vascular access specialists in all settings need to use technologies that invoke the least patient harm. The RyMed-5001(®) connector best protects the intraluminal pathway from bacteria compared with four other commonly used connectors in vitro.
authors.affiliation: School of Nursing, Medical College of Georgia, Augusta, Georgia, USA. cchernecky@mcg.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chernecky
authors.forename: Jennifer
authors.initials: J
authors.lastname: Waller
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D055499:Catheter-Related Infections / Q000209:etiology* / Q000517:prevention & control; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D057785:Catheters / Q000382:microbiology* / Q000592:standards; D002417:Cattle; D015169:Colony Count, Microbial; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D004867:Equipment Design; D004926:Escherichia coli / Q000254:growth & development / Q000302:isolation & purification; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation; D015233:Models, Statistical; D011358:Product Surveillance, Postmarketing; D011550:Pseudomonas aeruginosa / Q000254:growth & development / Q000302:isolation & purification; D013210:Staphylococcus / Q000254:growth & development / Q000302:isolation & purification